Raymond Hah, MD, is an assistant professor of orthopedic surgery at Los Angeles-based Keck School of Medicine of USC. He focuses his practice on minimally invasive spine surgical techniques.
Here, Dr. Hah discusses several exciting advancements in technology that include robotics, artificial intelligence and endoscopic procedures.
Question: What emerging technology are you most interested in today and why?
Dr. Raymond Hah: The technologic advancements of spine are occurring at an astounding pace. There are simply too many to list. As evidence continues to mount that cervical disc replacement has a small but significant effect on patient outcome and adjacent segment disease, particularly in the multilevel setting, I look forward to seeing the progression of its outcomes. I hope that the mid- to late-term results of this technology prove to be as promising and durable as the results to date.
I am also very excited to see the way that robotics will be applied beyond the limited scope of assisting planned pedicle screw placement, including potential motion restriction for 'no-fly zones,' automation of surgical decompression, and use of artificial intelligence and machine learning for anatomy recognition and guidance of surgical execution. An interesting overlap will also be as augmented reality becomes available in a commercially applicable fashion and the ways that this may assist surgeons intraoperatively. This could also prove to be an extremely valuable tool for presurgical planning as well as patient education.
Endoscopic spine treatment, which has typically been more popular in Asia is enjoying a surge of popularity within the United States with excellent results for carefully selected patients and lower surgical morbidity.
Last but perhaps the most imminent is the growth of technology to improve operative room efficiency and patient/operating team safety. There are now methods to reduce radiation exposure with camera-assisted technology. There is integration of neuromonitoring with fluoroscopic or CT guided navigation. There is a movement towards performing lumbar surgeries in a single lateral position to reduce operative time for the patient. These not only allow surgeons to work more efficiently with less time wasted, but also may have benefits in infection reduction and complication profiles. I would say that the future of spine is promising even without going into the biologic treatment of degenerative spinal conditions.
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